You may have a certain image that comes to mind when you think of a clinical trial. But did you know that a study can involve eating pizza? Our friend Scott Scolnick, who has written about being an enthusiastic foodie in the past, recently participated in a study at Joslin to optimize bolusing for pizza, and shares his experience:
There are certain foods that are nearly a surefire “spray and pray” and quite literally “hope for the best.” All too often, the “best” is rarely realized. And, at least for me, if it is, it was luck. When I was approached by the Joslin Institute for Transformational Technology Program, which is new group headed by Dr. Howard Wolpert in Boston, and they asked me to be a subject in a pizza study, I signed up right away. We all know pizza is one of the biggest challenges when it comes to bolusing. Whenever bolusing comes up in a Question of the Day on Glu, many remarks about pizza are sure to follow. Now don’t get me wrong, I love pizza, but this study really pushed my limits.
Here is how it went. The study involved 6 visits to Joslin Diabetes Center in Boston. They provided the food and supplies, and offered transportation to and from the clinic, because they were managing the administration of the insulin. During each visit, I ate a different kind of pizza to see how much insulin was required over a specific period of time to help them understand which amounts of insulin work best on different styles of pizza.
The first visit was to establish a baseline bolus. I had 50 grams of nondescript store-bought dough with marina sauce. They did an extended bolus; but I have no idea how much I was given and at what time. At each visit, they measured my blood glucose through vein blood draw and monitored my insulin levels at the same time. Once this baseline was established, the fun really began. If you love extra cheese on your pizza, this study is for you! On the same 50 grams of pizza dough, they piled on 900 calories of cheddar cheese. I asked them to make the dough nice and crispy, and they were more than happy to accommodate my particular request. I wanted crunch for crying out loud! So, the first round of the cheese overload was done using baseline and following the same protocol as the baseline test. Needless to say, it didn’t work quite so well. Through analyzing my blood glucose and insulin levels, the team developed an “optimized” pizza bolus.
Now, I once again don’t know the specific details of exactly how much insulin was needed over the course of the pizza being eaten. I’m only predicting it’s a whole lot more than I would give myself. My guess too, is that timing is of the essence with such a high amount of fat, especially with the “crispy crust” added in there.
Once all the participants have completed the study the researchers will gather the data and follow with poster presentations, the American Diabetes Association’s Scientific Sessions, and the like.
Step three involved creating an optimized pizza bolus. Again, I don’t know exactly what they did other than really give me a lot more insulin than I would normally do when I “spray and pray” for pizza. The results though, were quite simply amazing! While during each day-long visit, I did not know what my blood glucose levels were, but I sure did look back at my personal Dexcom. My blood sugars stayed between 65 and around 90 each of the three times that I did the optimized pizza bolus! My results were so on the mark, that they asked me to come back two more times to see if what they had figured out for me was “real” or just one of those diabetes flukes. It was real. I can’t wait to find out what they actually did so when I partake in one of my favorite indulgences, I don’t pay the inevitable price of my spray and pray anymore and constantly correct hours after! Pizza-eating exploration 2.0 here I come!